US8696692B2 - Tissue ligation device - Google Patents

Tissue ligation device Download PDF

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Publication number
US8696692B2
US8696692B2 US12/811,059 US81105908A US8696692B2 US 8696692 B2 US8696692 B2 US 8696692B2 US 81105908 A US81105908 A US 81105908A US 8696692 B2 US8696692 B2 US 8696692B2
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Prior art keywords
band
channel
medical device
tissue
protrusion
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US12/811,059
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US20100292793A1 (en
Inventor
Odd Höglund
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Resorbable Devices AB
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Vetok AB
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Assigned to RESORBABLE DEVICES AB reassignment RESORBABLE DEVICES AB ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: VETOK AB
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132—Tourniquets
    • A61B17/1322—Tourniquets comprising a flexible encircling member
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive

Definitions

  • the present invention generally relates to medical devices, and in particular to tissue ligation devices.
  • Ligation is the medical act of restricting blood flow in a blood vessel or other tissue.
  • tissue ligation is conducted using a ligature usually in the form of a thread or string, tied around the tissue.
  • Other prior art ligation devices include metal clips that are pinched around the tissue.
  • the act of tissue ligation can be very cumbersome, sometimes requiring the operation of more than one medical person.
  • tissue to become ligated needs to be lifted slightly from surrounding tissue in a subject.
  • tying the ligature thread around the lifted tissue typically requires two hands, in particular when pulling the thread tightly around the tissue and locking the thread with a knot. In these cases, some other medical person then has to lift the tissue from the surroundings or withdraw the surrounding tissue.
  • Metal clips have the disadvantage of requiring a further operation or surgical procedure for later removing the clips.
  • US 2005/0288674 discloses a bio-absorbable bone tie having a convex head and an elongated band used for securing fragments of a fractured bone together.
  • the bone tie is basically constructed as a traditional cable tie with the exception of the convex head.
  • the present invention overcomes these and other drawbacks of the prior art arrangements.
  • Yet another objective is to provide a medical device suitable for ligation of even very thin tissues.
  • the present embodiments involve a medical device suitable for tissue ligation.
  • the device comprises an elongated, flexible band equipped with ratchet members along at least a trailing band portion.
  • a device head is connected to the trailing end of the band and has a channel dimensioned for reception of a leading end of the band.
  • a lock member is connected to the device head and is disposed in connection with the channel.
  • the lock member comprises at least one lock tooth configured to interlock ratchet members in the band when the band is being pulled through the channel.
  • the lock member and the ratchet member mutually engage for allowing a forward movement of the band through the channel but restrain any backward band movement relative the head similarly to a reverse-motion brake of a cable tie.
  • a protrusion is provided in the device head in connection with the band entrance to the channel.
  • the band comprises a matching protrusion receiving member in connection with its trailing end.
  • the protrusion is arranged in the band on its trailing end with the matching protrusion receiving member present in the device head, preferably in one of its inner walls.
  • the receiving member is dimensioned for reception of the protrusion when the band is fed into the channel.
  • the protrusion and receiving member significantly reduce the band loop diameter when the band is fully pulled through the channel in the device head and can even achieve zero loop diameters. This is an important feature for tissue ligation, especially when handling very thin tissues, such as blood vessels in animals, including humans.
  • the protrusion has the further advantage in addition to reducing the loop diameter in that it has tissue engaging properties for reducing the risk that the medical device slips along the tissue during and after tissue ligation.
  • the device head preferably comprises at least one tissue engaging member that comprises elements that can grip into the tissue during and after ligation to thereby prevent the medical device from slipping along the tissue during and after the procedure, respectively.
  • An intermediate portion of the band is preferably U-shaped to thereby align the leading band end close to the device head. This further simplifies introducing the leading end into the head channel using a single hand of the operator.
  • the medical device is made of a resorbable material to be gradually degraded or dissolved after the ligation procedure, thereby relaxing the need for a further surgical operation to remove the medical device after tissue healing.
  • FIG. 1 is an illustration of a medical device according to an embodiment of the present invention
  • FIG. 2 is a magnification of the device head in the medical device of FIG. 1 from a first view
  • FIG. 3 is a magnification of the device head in the medical device of FIG. 1 from a second view
  • FIG. 4 is a magnification of the back side of the device head and the trailing band portion of the medical device of FIG. 1 ;
  • FIG. 5 is a magnification of the device head with the band fully inserted into the head channel
  • FIG. 6 is a magnification of the device head equipped with tissue engaging member on the band.
  • FIG. 7 is a flow diagram of a tissue ligation method according to an embodiment of the present invention.
  • the present invention relates to a medical device suitable for ligation of tissues and vessels in an animal body, such as a mammalian body, including a human body, and to a method of using such a device in performing tissue ligation.
  • the improved medical device, ligature, of the invention has significant advantages over the prior art thread-based ligatures. Firstly, the medical device can be handled by one hand of a medical person, leaving the other hand free for lifting the tissue to be ligated slightly out from the surrounding body. Furthermore, the locking of the medical device is simplified and does not require tying any knots in the limited space where the surgical operation is taking place in the animal or human body.
  • the medical device of the present invention is based on the principles of a cable tie (also denoted strap, zip tie, mouse belt, tie wrap, tie rap and quick draw in the art) for allowing forward motion of a band relative a lock member but restricting or even fully preventing backward movement of the band relative the lock member.
  • This feature of cable tie providing a reverse-motion brake, replaces the cumbersome operation of tying knots of thread ligatures and thereby significantly simplifies the ligation process.
  • FIG. 1 is an illustration of a particular embodiment of a medical device 100 according to the present invention suitable for tissue ligation.
  • the medical device 100 comprises an elongated, flexible band or strip 110 having a front side 118 and an opposite rear side 116 .
  • a trailing end 114 of the band 110 is attached and anchored to a head 130 of the medical device 100 .
  • the opposite leading band end 112 is adapted for insertion into a channel 135 running through the device head 130 .
  • the leading band end 112 can be pointed for facilitating guiding of the band 110 into the head channel 135 .
  • the end 112 could even be sharp to be able to penetrate tissue, when such a function is required.
  • the reverse-motion braking action of the invention is achieved through ratchet members 120 provided in at least a portion of the band 110 .
  • the ratchet members 120 are preferably arranged on at least the front side 118 of the band 110 but could also, or instead, be present on the rear side 116 as is illustrated in the figure.
  • the ratchet members 120 are arranged on at least the portion of the band 110 that is closest to the trailing end 114 and the device head 130 . As a consequence, the ratchets 120 can start at the trailing end 114 or close to the trailing end 114 and run at least a distance up through the band length towards the leading end 112 . It is actually possible to have ratchet members 120 along the whole length of the band 110 but for most practical applications it is adequate to have the ratcheting 120 up to a sub-part of the band lengths.
  • the important feature regarding the ratcheting length is that the ratchet members 120 should be provided at least up to a portion of the band length towards the leading end 112 to engage a lock member 140 in the device head 130 when the leading end 112 is fed into the channel 135 and the band 110 forms a loop around a tissue to be ligated.
  • the largest diameter of the loop when the lock member 140 first starts engaging with the ratchet members 120 as the leading band end 112 is pulled through the channel 135 should preferably be larger than the outer diameter of the tissue present in the loop.
  • the ratcheting 120 could therefore be from about one or few centimeters up to several centimeters.
  • the ratchet members 120 can, in a first embodiment, be realized as an array of holes or apertures through the band 110 as illustrated in the figure. These holes form, together with the intermediate band material, a ladder structure that can be engaged by the lock member 140 in the device head 130 to achieve the reverse-motion brake.
  • the ratchet members 120 are instead a plurality of notches in the front side 118 or the rear side 116 of the band 110 . These notches, thus, form indentations in the band 110 but not necessarily penetrate through the whole thickness of the band 110 as in the first embodiment.
  • a third ratcheting embodiment is to replace the holes or notches with a plurality of protruding members, such as ratchet teeth that extend a short distance from the front or rear side surface.
  • the device head 130 comprises the lock member 140 disposed in connection with the channel 135 , which is running through the head 130 and is dimensioned for reception of the band 110 .
  • the lock member 140 comprises at least one lock tooth or latching element 145 dimensioned to interlock ratchet members 120 defined in the band 110 .
  • the locking tooth 145 is arranged for step-by-step protrusion into the holes or notches as the band 110 is being fed through the channel 135 .
  • the locking tooth 145 engages with the protrusion of a ratchet teeth solution as the band 110 is being pulled through the channel 135 in the head 130 .
  • the inter-engagement between the lock member 140 and the ratchet member 120 permits forward movement of the band 110 through the channel 135 but restrains the band 110 against reverse movement through the channel 135 , thereby achieving a reverse-motion brake.
  • the locking tooth 145 of the lock member 140 is more clearly shown in FIGS. 2 and 3 . As is seen in these figures, the tooth 145 preferably ramps upward from the entrance side to the exit side of the channel 135 , while the opposite face of the tooth drops vertically. It is anticipated by the present invention that the lock member 140 may include multiple locking teeth 145 , such as positioned in series or as a train in connection with, preferably in, the head channel 130 .
  • the lock member 140 is disposed in connection with the channel 135 and is preferably, as is illustrated in FIGS. 1 to 3 , provided somewhere along the length of the channel 135 .
  • the lock member 140 could be provided in connection with the entrance and/or exit of the channel 135 in the device head 130 .
  • the lock member 140 can be situated in connection with the inner wall of the device head 130 that is on the same side of the channel 135 as the band 110 .
  • the ratchet members 120 are then provided on at least the front side of the band 110 .
  • the lock member 140 is provided on the inner wall opposite the side of the channel 135 at which the band 110 is anchored to the device head 130 .
  • the ratchet members 120 are therefore provided on at least the rear side 116 of the band 110 .
  • the medical device 100 of the present invention also comprises a protrusion 160 arranged, in this embodiment, in the device head 130 in connection with the entrance to the channel 135 .
  • a matching protrusion receiving member 150 is provided in the band 110 in connection with the trailing end 114 .
  • the receiving member 150 is dimensioned for allowing reception of the protrusion 160 .
  • the protrusion 160 is preferably arranged on the same side of the channel 135 in the device head 130 as the trailing end 114 is connected to the head 130 .
  • the receiving member 150 is preferably arranged in the portion of the band 110 that is in the interface or next to the transition between the band 110 and the device head 130 .
  • the respective positions of the protrusion 160 and the protrusion receiving member 150 are interchanged, i.e. the protrusion 160 is provided in the band 110 with the protrusion receiving member 150 on the device head 130 , which is further described herein.
  • FIG. 5 illustrates the device head 130 with the band 110 inserted into the channel 135 and fully pulled through the channel 135 . As is seen in the figure, no loop is present between the band 110 and the head 130 at this position as the protrusion 160 enters the receiving member 150 .
  • the protrusion receiving member 150 can be realized as an aperture or indentation 150 defined, in an embodiment, in the band 110 , where the aperture or indentation 150 has a dimension, i.e. inner circumference, and depth in the case of indentation, which matches the dimension, i.e. outer circumference and height, of the protrusion 160 to allow the protrusion 160 to enter the aperture or indentation 150 when the band 110 is fully or almost fully fed through the channel 135 .
  • the indentation is preferably provided in the front side 118 of the band 110 as illustrated in the figure.
  • the aperture 150 with its matching protrusion is also seen in FIG. 4 , which illustrates a backside view of a portion of the medical device 100 .
  • an intermediate portion 115 of the band 110 between the leading end 112 and the trailing end 114 is bent.
  • a preferred embodiment has a U-shaped intermediate portion 115 to position the leading band end 112 close to the device head 130 even when the band 110 has not yet been introduced into the channel 135 .
  • a medical person positions the ligating tissue in the space formed between the two, almost parallel, band portions between the trailing end 114 and the intermediate portion 115 and the leading end 112 and the intermediate portion 115 .
  • the person can, using one hand, introduce the leading band end 112 into the channel 135 and pull the band 110 therethrough to start the tissue ligation.
  • tissue engaging member 170 arranged on the side 132 of the device head 130 comprising the channel entrance.
  • the tissue engaging member 170 is more clearly seen in FIGS. 2 and 3 .
  • the member 170 preferably comprises multiple studs or hooks for engaging the tissue as the band 110 is being pulled through the channel 135 to restrict any relative motion and slipping between the tissue and the medical device 100 .
  • the tissue gripping or engaging action of the tissue engaging member 170 reduces the risk that the medical device 100 would slide off the tissue during and after ligation, which is a common problem today with (extensive) bleeding as a result.
  • Such ligature sliding according to the prior art during and/or after operation lengthens the operation time and/or requires a new surgical procedure to attach a new ligature around the tissue.
  • preventing or at least restricting any tissue sliding during and after ligation is an advantageous feature of the medical device 100 of the present invention.
  • the tissue engaging member 170 comprises a first tissue engaging member 170 A and a second tissue engaging member 170 B arranged on opposite sides of the channel 135 on the side of the device head 130 containing the channel entrance. More preferably, the two engaging members 170 A, 170 B are positioned on the device head 130 to protrude against the front side 118 of the band 110 , when the band 110 is fed through the channel 135 , as is seen in FIG. 5 . This means that the tissue engaging member 170 also helps reduce the band loop diameter to small values, such as zero or even negative diameter.
  • FIG. 5 clearly illustrates how the trailing end 114 of the band 110 aligns around tissue engaging member 170 at this band-feeding stage.
  • tissue engaging member 170 squeezes or crushes blood vessels in the tissue during ligation, thereby preventing or at least reducing any bleeding.
  • the tissue engaging member 170 is not necessarily arranged in the device head 130 .
  • the tissue engaging member 170 is then provided on the band 110 , preferably in connection with the trailing end 114 .
  • the tissue engaging member 170 is typically present on the front side 118 of the band for pressing, when the band 110 is being pulled into the channel 135 , the tissue to ligate against the device head 130 .
  • the invention also encompasses an embodiment having at least tissue engaging member in the device head 130 and at least one tissue engaging member on the band 110 .
  • FIG. 6 is a magnification of the device head 130 and the trailing band portion 114 of the medical device according to another embodiment.
  • This embodiment is basically similar to the embodiment discussed above in connection with FIG. 3 .
  • a tissue engaging member 175 is provided on the front side 118 of the band 110 in connection with the trailing portion 114 of the band 110 .
  • This tissue engaging member 175 is in the form of protrusions extending beyond the general surface of the front side 118 .
  • the protrusions may be in the form of ridges as shown in the figure but could alternatively be circular elevations, studs, hooks, or any other tissue engaging structure.
  • the tissue engaging member 175 can cover substantially the major portion of the front side 118 that is closest to the device head 130 possibly excluding portions of the front side 118 occupied by the ratchet members 120 .
  • the tissue engaging member 175 is substantially present on the rungs of the ladder formed by the ratchet member 120 and the portion of the band 110 beyond the rungs.
  • the tissue engaging member 175 is only present on the rungs or a portion thereof.
  • a further implementation is to have the tissue engaging member 175 on at least one of the stringers or stiles of the ladder structure up to a certain height from the device head 130 .
  • tissue engaging member 175 it is generally enough to have the tissue engaging member 175 arranged on the lowest rung as is illustrated in the figure. However, it is indeed possible to have the tissue engaging member 175 also provided on rungs more distance from the device head 130 .
  • the tissue engaging member 175 arranged on the band front side 180 has similar tissue engaging effects as the above-described tissue engaging members 170 A, 170 B provided in the device head 130 . In other words the tissue engaging member 175 reduces the risk that the medical device would slide of the tissue during and after the ligation.
  • the medical device 100 can be equipped with the band-arranged tissue engaging member 175 as the sole tissue engaging structure.
  • this tissue engaging member 175 is complemented with the one or both tissue engaging members 170 A, 170 B arranged in the device head 130 as illustrated in the figure.
  • a further embodiment is to only use the head-implemented tissue engaging member(s) 170 A, 170 B.
  • Still another embodiment of the medical device 100 does not have any dedicated tissue engaging members.
  • the design and operation of the protrusion 160 and the protrusion receiving member 150 will together achieve tissue engaging properties.
  • the medical device 100 of the embodiments basically achieves a double ligation, thereby significantly increasing the chances of successful tissue ligation.
  • a first ligation operation occurs between the first stringer or stile of the band 110 and the protrusion 160 in combination with the tissue engaging member 170 A.
  • a second ligation operation is correspondingly achieved between the second stringer or stile and the protrusion 160 in combination with the tissue engaging member 170 B.
  • two ligatures are often positioned next to each other on the tissue to ligate for security reasons.
  • Embodiments of the invention relax this need for usage of multiple separate ligatures as the medical device 100 itself can provide two ligations separated a few millimeters from each other, depending on the width of the protrusion 160 .
  • the device head 130 is integral with and extends from the trailing end 114 of the band 110 .
  • the medical device 100 can be moulded to a desired form and size.
  • the length of the band 110 could be from about one or few centimeters to one or more decimeters, with a thickness from the range of sub-millimeters to one or more millimeters and a width from the range of sub-millimeters to one or more millimeters.
  • the width of the band 110 must not necessarily be uniform.
  • the leading end 112 could be narrower than the trailing end 114 to thereby facilitate insertion of the leading end 112 into the head channel 135 .
  • the length of the band portion from the leading end 112 up to the intermediate portion 115 could be somewhat longer than the band portion from the trailing end 114 up to the intermediate portion 115 . This prevents the leading end 112 from easily dropping out of the device head 130 once introduced into the channel 135 .
  • the actual size of the medical device 100 is though not decisive for the teachings of the present invention and can instead be selected based on the particular application, animal/human subject and/or tissue to be ligated.
  • the protrusion has been arranged in the device head with the protrusion receiving member in the band.
  • the invention is though not limited thereto.
  • the protrusion is provided in the band in connection with the trailing end thereof, preferably in the front side of the band.
  • the protrusion receiving member is then arranged in the device head in connection with the band entrance to the channel, preferably on one of the inner walls defining the channel through the device head.
  • the same advantageous tissue ligation with small and even zero loop diameter can be achieved regardless of whether the protrusion is provided on the band with the protrusion receiving member in the device head or with the protrusion arranged in the device head and the protrusion receiving member in the band.
  • the protrusion receiving member if arranged in the device head, can be in the form of an aperture in one of the head walls.
  • the protrusion receiving member is in the form of an indentation in the head wall facing the channel and preferably being the head wall that is positioned on the same side of the device head as the band is anchored to the device head.
  • the lock member is preferably arranged in or in connection with the opposite inner wall of the device head, i.e. basically on the opposite inner wall than what has been illustrated in FIGS. 1-3 and 6 .
  • the material of the medical device is a biocompatible material, which does not have any major toxic or injurious effects on the animal or human body.
  • biocompatible materials include hypoallergenic materials traditionally employed for implantable medical devices.
  • plastic and metal (alloy) materials such as titanium, titanium alloys and stainless steel, can be used as long as the band material is flexible enough to allow being bent when pulling the leading band end through the channel in the device head.
  • bio-absorbable materials that can be left in the animal or human body and are resorbed by the body following a time after the surgical procedure.
  • bio-absorbable materials include glycolide polymers and copolymers, lactide trimethylene, carbonate, lactone, doxane, caprolactone, lactide polymers, such as formed from aliphatic lactone monomers selected from the group consisting of p-dioxanone, trimethylene carbonate, ⁇ -caprolactone, ⁇ -valerolactone, ⁇ -butyrolactone, ⁇ -decalactone, 2,5-diketomopholine, pivalolactone, ⁇ -diethylpropiolactone, ethylene carbonate, ethylene oxalate, 3-methyl-1,4-dioxane-2,5-dione, 3,3-diethyl-1,4-dioxan-2,4-dione, ⁇ -butyrolactone, 1,
  • bio-absorbable medical device is that no further surgical procedure is required for removing the medical device after the ligation operation has been completed and the ligated tissue has healed. This saves both costs and suffering from the relevant human or animal patient. Furthermore, non-absorbable devices can cause longterm negative reactions, such as granulomas.
  • FIG. 7 is a flow diagram illustrating the use of the medical device of the invention in a tissue ligation method.
  • the method starts in step S 1 , where a medical device according to the present invention is provided and arranged on a first side of the tissue to be ligated.
  • the leading end of the band is then inserted into the head channel to form a band loop enclosing the tissue in step S 2 . Due to the preferred U-shaped design of the intermediate band portion, the medical person can easily insert the band end into the channel.
  • the leading end is pulled through the channel to snare the tissue and achieve a ligation.
  • the design of the medical device allows the leading end to be pulled using a single hand operation, thereby leaving the other hand free from removing surrounding tissue that must not be ligated.
  • the band Due to the inter-engagement of the ratchet members and the lock member, the band is prevented from reverse movement and opening of the ligation loop.
  • the protrusion and matching protrusion receiving member allows the band to be tightly pulled through the band to minimize the band loop and achieve successful tissue strangulation.
  • the preferred tissue engaging members prevents the medical device from slipping along the tissue before during and after the surgical ligation procedure. If the device is made of a bio-absorbable material, it is gradually dissolved and resorbed, relaxing the need for a further surgical procedure to remove the device from the human or animal body.
  • any surplus band portion extending beyond the channel exit in the device head after fully pulling the band tight around the tissue can be cut off by the medical person.
  • the medical device of the invention can be used for ligating vastly varying tissues in both human and animal, preferably mammalian animal bodies.
  • Non-limiting examples include ligation of blood vessels, such as veins and arteries, for instance during laparoscopy; uterine horn; uterine body or testicular funicle, for instance during ovariohysterectomy and castration; during spleen ectomy or intestinal, pulmonary or cardiac procedures.
  • the device can also be used in any soft tissues surgery, in or outside the abdominal or thoracic cavity, where a ligation is desired.
  • the medical device of the present invention can therefore be utilized instead of traditional ligatures but also replace devices such as stapling equipment, ultrasonic scalpels, vessel sealing devices, transfixation ligatures, surgeons knot and other knots, e.g. Miller's knot.
US12/811,059 2008-01-14 2008-12-30 Tissue ligation device Active 2029-12-21 US8696692B2 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
SE0800082-0 2008-01-14
SE0800082A SE531907C2 (sv) 2008-01-14 2008-01-14 Anordning för vävnadsligering
SE0800082 2008-01-14
PCT/SE2008/051572 WO2009091313A1 (en) 2008-01-14 2008-12-30 Tissue ligation device

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US20100292793A1 US20100292793A1 (en) 2010-11-18
US8696692B2 true US8696692B2 (en) 2014-04-15

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EP (1) EP2234545B1 (sv)
SE (1) SE531907C2 (sv)
WO (1) WO2009091313A1 (sv)

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US20100292793A1 (en) 2010-11-18
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EP2234545A4 (en) 2015-03-25
EP2234545B1 (en) 2016-01-06

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